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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M, -8:00 A.M. <br /> <br />I am performing work on a property I own or O6OUpy. <br />I ~r'h a registered builder OR the authorized representative <br /> of a registered builder. <br />The work will be performed by a registered builder. <br />Other <br /> <br /> DATE: :1/06/87 TIME: 10:57:57m <br />OWNERI ' fAX LOT; ~CATEGORY: <br /> BUTLER, GEORGE L. & EDNA M. : R <br /> <br />S~TUS ^OO~6SS; bd~§¥~udffidN ~¥"~: i OOOUPANOY: <br /> <br /> 8721 L~TTLE RD SE ~C~+~fBi~; ~'686; ::b~Cu¢ANI' LOAD: <br /> AU~VZ LLE OR 9?325 ' <br /> ~RZ~ COUNTY ~ NO ~ <br /> <br />USE Of BULLDtNG: <br /> <br />'11459 STAYTON RD SE ~ <br />STAYTON, OR 9?383 <br /> : SITE NUMBER: 3033 <br />PHONE; ? 69-5509 X:--.--...~ ~ VALUATZ~: <br /> <br /> : SEBflON: ~ TO~S~;¢: ~ANGE: ] ZONe: <br /> 36 ~ 8S ~ 2N : EFU <br /> <br />LOT: <br /> <br />WIDTH. <br /> <br />BLOCK: , MAP; <br /> 51 <br />DEPTH: <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERMIT OR APPLICATION NO: 900540? <br /> <br />CONTRACTOR, NO. <br />BUTLER, GEORGE L. & EDNA <br />11459 STAYTON RD SE <br />STAYTON. OR 9?383 <br />PHONE: 769-5503 <br /> <br />MATER SUPPLY= P~4 <br />TEST HOLES REABY~ <br />SITE EVALUATION NUMBER; <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 9-27-85 <br />PREVIOUS NO. BECRGONS; 3 <br /> <br /> ITEN <br />AUTHORIZATION NOTICE - FLD, VISIT <br /> <br />PAYEE: BUTLER, GEORGE L. & EDNA <br />RECEIVED BY: JB <br /> <br /> QUANTITY AMOUNT <br /> $65,00 <br /> <br />TOTAL ASS. ESSED:FEES $65_0O <br />: :PREV~OUSREOEI~TS $0,00 <br />· ~IS:REOEIP% , , $85.00 <br /> <br /> ,RECE[PT NO: 59?4 <br /> TY~E'~] OK, CHECK ~: 2213 <br /> <br />SEE ATTACHEC BOCUMENT FOR REOLJIREMENTS <br />~ lt~S IS NOT A ~.~IIT. THIS APPLI~TION t~IJST, ~'TIJROU6H A REVIEW PROCESS bi-tEl~i THE <br />~'OM.JOf~IN6 HLJST 8E COiVlPLETEO. ,'[TIS ,THE;-RE~;~ISiB,ZlLITY OF THE APPLICANT TO A,I~SURE THAT <br />ALL NECESSARY INFORMATION HAS <br /> 8EB~I~PROVI DEC;, <br /> <br />PLAN REVIEN: BY__~%1,J ~__/~-'' ...... DATE ,.~.,,LT.~%',~_ ]' CITY JURISDICTION; BY ........ CATE ......... <br />R,E~ARKS: AUTN .NOTICE ¢~l~t8122 <br /> <br /> <br />